Sunday 11 January 2009

Dementia


We woke up this morning and were told that GPs are to get extra training in something but we cannot remember what it was?

We used to know but we forget that we had lots of lectures on it at medical school and how we should investigate it to rule out serious, but incredibly rare causes of it, but then we forget. When we were junior grunts we saw lots of patients with this disease and spent hours seeing patients we admitted with this disease in A&E, on medical and surgical wards but we have forgotten all of this.

We did then do GP training and forgot all we learnt about this disease but fortunately the politicians did remind us that we have forgotten and about how hard it is to diagnose and how it can take months or even years to come to a diagnosis but with “re education” we will be able to spot it in seconds as politicians can do.

They however know better as they see this forgotten disease on a daily basis in their once weekly “surgeries” for they say “yes, Granny is a problem, go and see your GP” and do nothing about Granny for they control the money.

Reading this we must be suffering from something but we cannot remember all those years of training and what we are suffering from. Do we all need an urgent consult with a politician?

Unfortunately while the Party has just discovered “dementia” many families have discovered how lacking the NHS is in its provision for this disease.

The caring ones struggle against the progressive loss of function that dementia brings and even fight the local Politburos who regard it as an expensive inconvenience to treat someone who will die and never get better but in living will cost more with each painful year of functional decline. The less caring dump and run at A&E.

ND and the team have seen the same disease process year after year despite the fact that we know nothing about it. The desperate call “you have to do something about this” almost always for a home visit when Granny wanders the street at night in sub zero temperatures in her nightdress or Granddad starts thinking that petrol and vinegar will sort his bowels out as he has a fag on the toilet are not too uncommon scenarios to frontline NHS staff. But not for the politicians for they know what Northern Docs do not.

Dementia is like childhood but in reverse. Children start as completely dependant but with nurturing and education gradually become fully independent. Dementia patients start as fully independent people who regardless of how much nurturing or help is given become progressively more dependant until finally, and often mercifully, they are released by Death.

The human brain is a very subtle, delicate organ, which if we can quote from medical school “in life has the consistency of yoghurt”. It is easily damaged for example by a baseball bat that can change a Nobel prize winning scientist to an incontinent rambling idiot in seconds. Unfortunately age too can destroy an intelligent self functioning, caring individual into a dement but the process can take years.

Whilst we can potentially prevent the Nobel prize winner’s argument with a baseball bat we can do sod all against aging. If you live long enough it may happen to you and you won’t care because you may not know but fortunately the politicians will. They will be there to care for you as they are now “re educating” doctors in all they have forgotten or rather did not know (if you believe the Party).

The dementia process is irreversible, we do not as yet understand it, but nonetheless re education at the Gulags will make us better able to “treat” it.

Extra funding and resources will off course be of no help to the families who struggle with dementia as it will not be provided. Ticking a few “re education” boxes is so cheap compared with providing adequate care in the community (or anywhere) for a dementia sufferer.

Praise be to the Party and can they tell us what we are all suffering from and how to treat it as we have forgotten? Clearly GPs need “collective re education” (sound familiar comrades?) and the Party clearly feels GPs should be sent to the Gulags for this.

(This piece is respectfully dedicated to a family in Northernshire who have fought the Party and its local Politburo for years to look after their parents and got nothing from the Party without a huge fight despite the patient, their spouse and children all having worked and paid taxes for all of their working lives. ND’s team have huge respect for these fellow Resistance Fighters. This is dementia in the real world. A war against the uncaring NHS management.

We will see if St. Fiona Phillips has the same problems as those outside of celeb la la land do. There is a programme on channel 4 tonight on this subject. We hope it is better than the aforementioned Sts coverage of MMR over the years) .

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